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CAROSPIR
CHF and arrhythmias
Edema
Hypertension
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Drug Name:

CAROSPIR Rx

Generic Name and Formulations:
Spironolactone 25mg/5mL; oral susp; banana flavor.

Company:
CMP Pharma

Therapeutic Use:

Indications for CAROSPIR:

To increase survival, manage edema, and to reduce hospitalization for heart failure (NYHA class III–IV) and reduced ejection fraction when used in addition to standard of therapy.

Adult:

Not therapeutically equivalent to Aldactone. If serum potassium ≤5.0mEq/L and eGFR >50mL/min/1.73m2: initially 20mg (4mL) once daily; may increase to 37.5mg (7.5mL) daily if tolerant. May decrease to 20mg (4mL) every other day if hyperkalemia develops. If eGFR 30–50mL/min/1.73m2: consider initiating at 10mg (2mL). If dose >100mg required, use another formulation.

Children:

Not established.

Contraindications:

Hyperkalemia. Addison's disease. Concomitant eplerenone.

Warnings/Precautions:

Increased hyperkalemia risk with renal impairment; monitor closely. Monitor serum potassium within 1 week of initiation or titration and periodically thereafter; reduce dose or discontinue if hyperkalemia occurs. Monitor volume status, renal function, serum electrolytes, uric acid, and blood glucose periodically. Hepatic impairment. Elderly. Pregnancy; avoid. Nursing mothers.

Pharmacological Class:

Diuretic (K+ sparing).

Interactions:

See Contraindications. Avoid K+-sparing diuretics, K+-supplements, K+-containing salt substitutes. Hyperkalemia more likely with ACE inhibitors, ARBs, aldosterone blockers, NSAIDs, heparin, LMWH, trimethoprim. Monitor for lithium toxicity. May be antagonized by NSAIDs, acetylsalicylic acid; monitor closely. Worsening renal function with concomitant nephrotoxic drugs (eg, aminoglycosides, cisplatin, NSAIDs). Potentiates digoxin; monitor. Caution with cholestyramine.

Adverse Reactions:

Gynecomastia, hyperkalemia, hypotension, hyponatremia, hypomagnesemia, hypocalcemia, hypochloremic alkalosis, hypovolemia, hyperglycemia, gastritis, diarrhea, cramping, nausea, vomiting, ataxia, drowsiness, headache, rash; neurologic impairment, coma.

Generic Availability:

NO

How Supplied:

Susp—118mL, 473mL

Indications for CAROSPIR:

Edema associated with hepatic cirrhosis.

Adult:

Not therapeutically equivalent to Aldactone. Cirrhosis (initiate in hospital setting and titrate slowly): initially 75mg (15mL) daily in single or divided doses. If dose >100mg required, use another formulation. As sole agent for diuresis: administer for 5 days before increasing dose to obtain desired effect.

Children:

Not established.

Contraindications:

Hyperkalemia. Addison's disease. Concomitant eplerenone.

Warnings/Precautions:

Increased hyperkalemia risk with renal impairment; monitor closely. Monitor serum potassium within 1 week of initiation or titration and periodically thereafter; reduce dose or discontinue if hyperkalemia occurs. Monitor volume status, renal function, serum electrolytes, uric acid, and blood glucose periodically. Hepatic impairment. Elderly. Pregnancy; avoid. Nursing mothers.

Pharmacological Class:

Diuretic (K+ sparing).

Interactions:

See Contraindications. Avoid K+-sparing diuretics, K+-supplements, K+-containing salt substitutes. Hyperkalemia more likely with ACE inhibitors, ARBs, aldosterone blockers, NSAIDs, heparin, LMWH, trimethoprim. Monitor for lithium toxicity. May be antagonized by NSAIDs, acetylsalicylic acid; monitor closely. Worsening renal function with concomitant nephrotoxic drugs (eg, aminoglycosides, cisplatin, NSAIDs). Potentiates digoxin; monitor. Caution with cholestyramine.

Adverse Reactions:

Gynecomastia, hyperkalemia, hypotension, hyponatremia, hypomagnesemia, hypocalcemia, hypochloremic alkalosis, hypovolemia, hyperglycemia, gastritis, diarrhea, cramping, nausea, vomiting, ataxia, drowsiness, headache, rash; neurologic impairment, coma.

Generic Availability:

NO

How Supplied:

Susp—118mL, 473mL

Indications for CAROSPIR:

Adjunct in hypertension.

Adult:

Not therapeutically equivalent to Aldactone. Initially 20–75mg (4–15mL) daily in single or divided doses. Titrate at 2 week intervals. If dose >100mg required, use another formulation.

Children:

Not established.

Contraindications:

Hyperkalemia. Addison's disease. Concomitant eplerenone.

Warnings/Precautions:

Increased hyperkalemia risk with renal impairment; monitor closely. Monitor serum potassium within 1 week of initiation or titration and periodically thereafter; reduce dose or discontinue if hyperkalemia occurs. Monitor volume status, renal function, serum electrolytes, uric acid, and blood glucose periodically. Hepatic impairment. Elderly. Pregnancy; avoid. Nursing mothers.

Pharmacological Class:

Diuretic (K+ sparing).

Interactions:

See Contraindications. Avoid K+-sparing diuretics, K+-supplements, K+-containing salt substitutes. Hyperkalemia more likely with ACE inhibitors, ARBs, aldosterone blockers, NSAIDs, heparin, LMWH, trimethoprim. Monitor for lithium toxicity. May be antagonized by NSAIDs, acetylsalicylic acid; monitor closely. Worsening renal function with concomitant nephrotoxic drugs (eg, aminoglycosides, cisplatin, NSAIDs). Potentiates digoxin; monitor. Caution with cholestyramine.

Adverse Reactions:

Gynecomastia, hyperkalemia, hypotension, hyponatremia, hypomagnesemia, hypocalcemia, hypochloremic alkalosis, hypovolemia, hyperglycemia, gastritis, diarrhea, cramping, nausea, vomiting, ataxia, drowsiness, headache, rash; neurologic impairment, coma.

Generic Availability:

NO

How Supplied:

Susp—118mL, 473mL

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